Australian Dance Tunes for Fiddle
Book & CD order form

You can pay by Credit Card (Visa / Mastercard / Bankcard) or by Cheque or Money order (in Australian dollars). Please fill out form and then print.

Credit card orders can be faxed to: (61) 2 4257 1787

Cheques, money order or credit card payment can be posted to:
Wongawilli Colonial Dance Club Inc.
PO Box 17, Albion Park, NSW, 2527. Australia

Enquiries to David De Santi: phone (61) 2 4257 1788, fax (61) 2 4257 1787
email: ddesanti@keira.hotkey.net.au

Please provide the following contact information:

Name

Street address

Address (cont.)

City

State

Postcode

Work Phone

Home Phone

FAX

E-mail

Please provide the following items:

QTY Value Total

1 Australian Dance Tunes for Fiddle, Book & CD $25 $

2 Postage & packaging (in Australia), first 2 copies $4 $

3 Postage & packaging for more than 2 items, add 50c each additional copy $0.50 $

TOTAL

$

PAYMENT DETAILS

Payment type

Cardholder name

Card number

Expiration date

Cardholder signature

Please fill out form and then print.
Return to Australin Dance Tunes for Fiddle page.
Return to Wongawilli Colonial Dance Club page.

email enquiries: ddesanti@keira.hotkey.net.au

Name
Street address
Address (cont.)
City
State
Postcode
Work Phone
Home Phone
FAX
E-mail

		QTY	Value	Total
1	Australian Dance Tunes for Fiddle, Book & CD		$25	$
2	Postage & packaging (in Australia), first 2 copies		$4	$
3	Postage & packaging for more than 2 items, add 50c each additional copy		$0.50	$
TOTAL				$

PAYMENT DETAILS
Payment type
Cardholder name
Card number
Expiration date
Cardholder signature

Australian Dance Tunes for Fiddle Book & CD order form

Carrawobbity Press, 18 April 2001

Australian Dance Tunes for Fiddle
Book & CD order form